During the past years increasingly more centers investigated the usage of Campath-1H induction therapy in combination with the calcineurin inhibitors, MMF in the absence or with a short course of steroids. A recent single-centre, retrospective study of SPK transplant recipients involved two treatment arms with Campath (n=50) and Thymoglobuline (n=58). The induction dose of Campath was 30mg and 6mg/kg for Thymoglobuline. Additionally all recipients received a prednisone-free maintenance immunosuppressive regimen of Tacrolimus and Sirolimus or MMF. The 3-year patient and graft survivals were excellent and similar between the treatment arms. The mean creatinine value 1-year post-transplant was however lower in the Campath subgroup (1.30 vs. 1.44 mg/dL). Furthermore advantages of Campath were shown by a trend of decreased rates of CMV infection, PTLD and it was also less expensive.6 The purpose of a further study was to evaluate Campath-1H preconditioning and Tacrolimus monotherapy in pancreas transplant recipients. Thirty-seven consecutive pancreas transplants (20 SPK, 10 PAK and 7 PTA) were followed up for 7 months, utilizing 30mg Campath-1H preconditioning. Two grams of intravenous methylprednisolone were administered, one prior to starting the Campath-1H and another at reperfusion. Patient survival was 100%. Pancreas and kidney graft survivals were 94% and 90%, respectively. Interestingly, all rejection episodes were preceded by tacrolimus trough levels <9.0 ng/ml for an extended period of time, while allograft rejection was not observed in pancreases or kidneys if the tacrolimus was >10 ng/ml. During the study period no infectious complications were seen. Although follow-up was short, these results suggest that a regimen of Campath-1H induction and tacrolimus monotherapy represents an effective immunosuppressive protocol for pancreas transplant recipients.7